71 Cannery Cir owte ran'uenerai insurance t..umpany U
A Stock Company With Home Offices in Bloomington, Illinois
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PO Box 2356 StateFarin
Bloomington IL 61702-2356 c:3'c �
AT, H op2-23C1-FBoc F HW 002693 3200 RENEWAL DECLARATIONS
CAMPBELL REDEVELOPMENT AGENCY
70 N 1ST ST
CAMPBELL CA 95008-1458
AMOUNT DUE: None
Payment is due by BILLED THROUGH SFPP
Illllllllllllnlll ll Ilji IIII IIIIIIIIII
Policy Number: 05-NN-8588-0
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Policy Period: 12 Months
Effective Dates: NOV 23 2023 to NOV 23 2024
The policy period begins and ends at 12:01 am standard
time at the residence premises.
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Homeowners Policy Your State Farm Agent
STEFELY INS AND FIN SVCS INC
Location of Residence Premises, 20395 PACIFICA DR STE 108
71 CANNERY CIR CUPERTINO CA 95014-3016
CAMPBELL CA 95008-1443
Phone:(408)255-3212
Construction: Frame Roof Material: Composition Shingle
Year Built: 1999 Roof Installation Year: Default to Year Built
Automatic Renewal
If the POLICY PERIOD is shown as 12 MONTHS,this policy will be renewed automatically subject to the premiums, rules,
and forms in effect for each succeeding policy period. If this policy is terminated,we will give you and the Mortgagee/Lien-
holder written notice in compliance with the policy provisions or as required by law.
IMPORTANT MESSAGES
This policy includes building code upgrade coverage of $48,940. Refer to the Important Notice for
possible terms,limits, conditions,or restrictions.
Please help us update the data used to determine your premium. Contact your agent with the year each of •
your home's utilities (heating/cooling, plumbing,or electrical)and roof were last updated.
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PREMIUM
Annual Premium $812.00
Your premium has already been adjusted by the following:
Home/Auto Discount Claim Record Discount •
Total Premium $812.00
Prepared SEP 27 2023 •• Page 1 of 3
H0-2000 Irisdor.art?as an/era. 2Ge 1pee t`Q au,kip min cus'tON
011944 920 Al
I01F1U60Rl 04-04-2016
2. StateFanny
NAMED INSURED MORTGAGEE AND ADDITIONAL INTERESTS
ROSENFELD, JENNIFER
Mortgagee
WELLS FARGO BANK NA Loan Number:
ITS SUCC AND/OR ASSIGNS 650650644580219
' PO BOX 8546
SPRINGFIELD OH 45501-8546
3rd Mortgagee 2nd Mortgagee
CAMPBELL REDEVELOPMENT AGENa' an Number: TECHNOLOGY CREDIT UNION Loan Number:
70 N 1ST ST N/A ISAOA/ATIMA 32163280
CAMPBELL CA 95008-1458 PO BOX 460708
SAN ANTONIO TX 78246-0708
SECTION I -PROPERTY COVERAGES AND LIMITS
Coverage Limit of Liability
A Dwelling $ 489,400
Other Structures $ 48,940
B Personal Property $ 367,050
C Loss of Use $ 146,820
Additional Coverages
Arson Reward $1,000
Credit Card, Bank Fund Transfer Card, Forgery, and Counterfeit Money $1,000
Debris Removal Additional 5% available/$1,000 tree debris
Fire Department Service Charge $500 per occurrence
Fuel Oil Release $10,000
Locks and Remote Devices $1,000
Trees, Shrubs, and Landscaping 5% of Coverage A amount/$750 per item
SECTION II -LIABILITY COVERAGES AND LIMITS
Coverage Limit of Liability
L Personal Liability (Each Occurrence) $ 300,000
Damage to the Property of Others $ 1,000
M Medical Payments to Others (Each Person) $ 1,000
INFLATION .
Inflation Coverage Index:415.4
DEDUCTIBLES
Section I Deductible Deductible Amount
All Losses 1/2% $ 2,447
LOSS SETTLEMENT PROVISIONS
Al Replacement Cost- Similar Construction
B1 Limited Replacement Cost - Coverage B
H0-2000
Page 2 of 3
u
05-NN-8588-0 :• StateFarm°
FORMS,OPTIONS,AND ENDORSEMENTS
HW-2105 Homeowners Policy
Option ID Increase Dwlg up to $97,880
Option OL Ordinance/Law 10%/ $48,940
Option JF Jewelry and Furs $1,500 Each
Article/$2,500 Aggregate
HO-2420 Form 438bfu NS Lndr Loss Pay
HO-2779 Wildfire Response End
HO-2362 State of Emergency Amendatory
HO-2213 Amendatory Endorsement
N ADDITIONAL MESSAGES
Eno The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your home,
including an approximate cost for labor and materials in your area, and specific information that you have
provided about your home.
CALIFORNIA LAW REQUIRES US TO PROVIDE THE FOLLOWING NOTICE: Our records indicate that you have
not purchased earthquake coverage.
Anti-Fraud Disclosure - For your protection California law requires the following to appear on this form:Any person
who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for
the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.
State Farm uses geographic rating that considers wildfire risk associated with your address. The range of
available premium adjustments is currently -41.7%to 376.9%, and your adjustment is -34.6%. If the listed
address is not correct, the premium adjustments may be impacted. To appeal the premium due to an
incorrect address, please contact your State Farm®agent.
Other limits and exclusions may apply- refer to your policy
Your policy consists of these Declarations,the Homeowners Policy shown above,and any other forms and endorsements
that apply, including those shown above as well as those issued subsequent to the issuance of this policy.
This policy is issued by the State Farm General Insurance Company.
Participating Policy
You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in
accordance with the Company's Articles of Incorporation,as amended.
In Witness Whereof,the State Farm General Insurance Company has caused this policy to be signed by its President and
Secretary at Bloomington, Illinois.
Secretary President
Prepared SEP 27 2023 Page 3 of 3
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